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目的探讨急性有机磷农药中毒的救治经验。方法对2007年12月至2010年12月收治的72例急性有机磷农药中毒患者的临床资料进行回顾性分析。结果 72例患者中,对硫磷中毒36例,氧化乐果14例,敌敌畏12例,马拉硫磷6例,不明品名4例。给予急诊洗胃67例(其中反复洗胃12例),催吐5例;采用血液净化18例;呼吸机辅助呼吸48例。经综合救治(包括阿托品、胆碱脂酶复活剂及纳洛酮的联合应用),69例(95.8%)康复出院,3例(4.2%)死亡。结论在救治急性有机磷农药中毒时,及早开放气道,彻底洗胃,用药与洗胃同步进行,尽早以胆碱脂酶复活剂、乙酰胆碱拮抗剂及纳洛酮联合使用,及时血液灌流治疗,积极预防和治疗并发症,能获得临床疗效满意。
Objective To explore the treatment experience of acute organophosphorus pesticide poisoning. Methods The clinical data of 72 patients with acute organophosphorus pesticide poisoning admitted from December 2007 to December 2010 were retrospectively analyzed. Results Of the 72 patients, 36 were parathion poisoning, 14 were omethoate, 12 were dichlorvos, 6 were malathion, and 4 were unknown. 67 cases were given emergency gastric lavage (including 12 cases of gastric lavage), 5 cases were elicited, 18 cases were purificated by blood, and 48 cases were assisted by ventilator. After the comprehensive treatment (including the combination of atropine, cholinesterase resuscitator and naloxone), 69 (95.8%) patients were discharged and 3 patients (4.2%) were discharged. Conclusions In the treatment of acute organophosphorus pesticide poisoning, the airway is opened as soon as possible and the gastric lavage is thoroughly done. The medicine is used simultaneously with gastric lavage. The combination of cholinesterase activator, acetylcholine antagonist and naloxone, Active prevention and treatment of complications, clinical efficacy can be satisfied.